Periodontal regeneration by leukocyte and platelet‐rich fibrin with autogenous bone graft versus enamel matrix derivative with autogenous bone graft in the treatment of periodontal intrabony defects: A randomized non‐inferiority trial

2020 ◽  
Vol 91 (12) ◽  
pp. 1595-1608
Author(s):  
Michele Paolantonio ◽  
Marcella Di Tullio ◽  
Marta Giraudi ◽  
Luigi Romano ◽  
Lorenzo Secondi ◽  
...  
Keyword(s):  
Bone Graft ◽  
Periodontal Regeneration ◽  
Autogenous Bone Graft ◽  
Enamel Matrix Derivative ◽  
Autogenous Bone ◽  
Enamel Matrix ◽  
Intrabony Defects ◽  
Platelet Rich Fibrin ◽  
Matrix Derivative

scholarly journals Enamel Matrix Derivative and Autogenous Bone Graft for Periodontal Regeneration of Intrabony Defects in Humans: A Systematic Review and Meta-Analysis

Materials ◽  
2019 ◽  
Vol 12 (16) ◽  
pp. 2634 ◽  
Author(s):  
Marco Annunziata ◽  
Angelantonio Piccirillo ◽  
Francesco Perillo ◽  
Gennaro Cecoro ◽  
Livia Nastri ◽  
...  
Keyword(s):  
Bone Graft ◽  
Meta Analysis ◽  
Periodontal Regeneration ◽  
Autogenous Bone Graft ◽  
Enamel Matrix Derivative ◽  
Autogenous Bone ◽  
Controlled Trials ◽  
Enamel Matrix ◽  
Intrabony Defects ◽  
Matrix Derivative

The combination of enamel matrix derivative (EMD) with an autogenous bone graft in periodontal regeneration has been proposed to improve clinical outcomes, especially in case of deep non-contained periodontal defects, with variable results. The aim of the present systematic review and meta-analysis was to assess the efficacy of EMD in combination with autogenous bone graft compared with the use of EMD alone for the regeneration of periodontal intrabony defects. A literature search in PubMed and in the Cochrane Central Register of Controlled Trials was carried out on February 2019 using an ad-hoc search string created by two independent and calibrated reviewers. All randomized controlled trials (RCTs) comparing a combination of EMD and autogenous bone graft with EMD alone for the treatment of periodontal intrabony defects were included. Studies involving other graft materials were excluded. The requested follow-up was at least 6 months. There was no restriction on age or number of patients. Standard difference in means between test and control groups as well as relative forest plots were calculated for clinical attachment level gain (CALgain), probing depth reduction (PDred), and gingival recession increase (RECinc). Three RCTs reporting on 79 patients and 98 intrabony defects were selected for the analysis. Statistical heterogeneity was detected as significantly high in the analysis of PDred and RECinc (I2 = 85.28%, p = 0.001; I2 = 73.95%, p = 0.022, respectively), but not in the analysis of CALgain (I2 = 59.30%, p = 0.086). Standard difference in means (SDM) for CALgain between test and control groups amounted to −0.34 mm (95% CI −0.77 to 0.09; p = 0.12). SDM for PDred amounted to −0.43 mm (95% CI −0.86 to 0.01; p = 0.06). SDM for RECinc amounted to 0.12 mm (95% CI −0.30 to 0.55. p = 0.57). Within their limits, the obtained results indicate that the combination of enamel matrix derivative and autogenous bone graft may result in non-significant additional clinical improvements in terms of CALgain, PDred, and RECinc compared with those obtained with EMD alone. Several factors, including the surgical protocol used (e.g. supracrestal soft tissue preservation techniques) could have masked the potential additional benefit of the combined approach. Further well-designed randomized controlled trials, with well-defined selection criteria and operative protocols, are needed to draw more definite conclusions.

scholarly journals Evaluation of intrabony defects treated with platelet-rich fibrin or autogenous bone graft: A comparative analysis

2015 ◽  
Vol 09 (01) ◽  
pp. 100-108 ◽  
Author(s):  
Ashish Mathur ◽  
Vivek Kumar Bains ◽  
Vivek Gupta ◽  
Rajesh Jhingran ◽  
G. P. Singh
Keyword(s):  
Bone Graft ◽  
Primary Objective ◽  
Autogenous Bone Graft ◽  
Autogenous Bone ◽  
Intrabony Defects ◽  
Pocket Depth ◽  
Platelet Rich Fibrin ◽  
Probing Pocket Depth ◽  
Bivariate Correlation ◽  
Open Flap Debridement

ABSTRACT Objective: The primary objective of this study was to compare clinically and radiographically the efficacy of autologous platelet rich fibrin (PRF) and autogenous bone graft (ABG) obtained using bone scrapper in the treatment of intrabony periodontal defects. Materials and Methods: Thirty-eight intrabony defects (IBDs) were treated with either open flap debridement (OFD) with PRF or OFD with ABG. Clinical parameters were recorded at baseline and 6 months postoperatively. The defect-fill and defect resolution at baseline and 6 months were calculated radiographically (intraoral periapical radiographs [IOPA] and orthopantomogram [OPG]). Results: Significant probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, defect fill and defect resolution at both PRF and ABG treated sites with OFD was observed. However, inter-group comparison was non-significant (P > 0.05). The bivariate correlation results revealed that any of the two radiographic techniques (IOPA and OPG) can be used for analysis of the regenerative therapy in IBDs. Conclusion: The use of either PRF or ABG were effective in the treatment of three wall IBDs with an uneventful healing of the sites.

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